[Intraoperative cranial nerves monitoring under partial neuromuscular relaxation during cerebellopontine angle tumor resection].
OBJECTIVE
To evaluate the efficacy of multiple cranial nerves monitoring under partial Seventy elective neuromuscular relaxation during cerebellopontine angle (CPA) tumor resection.


METHODS
patients undergoing CPA tumor resection via microneurosurgery were randomly allocated to 2 equal groups: Group FN receiving intraoperative facial nerve (NF) monitoring and Group MN receiving monitoring of multiple nerves: trigeminal nerve, glossopharyngeal nerve, accessory nerve or hypoglossal nerve other than the FN which were considered at risk by the neurosurgeon preoperatively. The manipulation procedure were modified according to cranial nerves monitoring and neuromuscular relaxation was maintained at train of four stimulation (TOF)=3 by continuous vencronium infusion during the acoustic neuroma resection. The function of the cranial nerves monitored were evaluated preoperatively and 8 days postoperatively.


RESULTS
Discernable and legible images of electromyographic wave complex were obtained during cranial nerve mapping and monitoring under intraoperative partial neuromuscular relaxation form all the patients. The facial nerve function of 4 patients exacerbated (from H-B grade I-II to grade III-IV) in both groups, and one new glossopharyngeal nerve function deficiency was found in Group FN, and one new hypoglossal nerve function deficiency was found in Group MN postoperatively.


CONCLUSIONS
Intraoperative cranial nerves monitoring under partial neuromuscular relaxation is feasible. Multiple cranial nerves combined with facial nerve monitoring seems unable to increase the short-term protective effects of nerve function after CPA tumor resection.
Zhang
Jun
J
Department of Anesthesiology, Huashan Hospital Fudan University, Shanghai 200040, China.
Yang
Cheng
C
Gu
Hua-hua
HH
Liang
Wei-min
WM
D000328:Adult; D002528:Cerebellar Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000601:surgery*; D003391:Cranial Nerves / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009126:Muscle Relaxation